Tongue base abscess requiring emergent tracheotomy: A complication of volumetric RFA

Abstract

Objectives: A case of a near-obstructing tongue base abscess secondary to radiofrequency volumetric tongue-base reduction is presented. Methods: Case report and review of the literature. Results: A 39-year-old woman presented with severe odynophagia, “hot-potato” voice, and increasing respiratory difficulty 8 days following a radiofrequency volumetric tongue-base reduction procedure. Examination revealed marked fullness of her tongue base with vallecular effacement, significant narrowing of the oropharyngeal airway, and exquisite tenderness to palpation over the tongue base and neck. CT scan revealed a large, rim-enhancing tongue base fluid collection measuring 3.3 × 5.2 × 3.8 cm. The diagnosis was felt to be consistent with an abscess, and due to the large size of the lesion and impending airway obstruction, the patient was taken to the operating room for emergent tracheotomy and drainage of the abscess. Conclusion: The complication of tongue base abscess secondary to radiofrequency ablation procedures has been well described in the literature, however, this is the first reported case of a tongue-base abscess requiring emergent tracheotomy. Clinical complication avoidance strategies for tongue-base RFA, which have been previously recommended, should be followed closely in an attempt to minimize the risk of this potentially life-threatening complication.